- What Is
What is a ventricular repair (cardiorrhaphy) procedure?
Ventricular repair is also called cardiorrhaphy. It is a lifesaving procedure performed for cardiac (heart) trauma in the emergency room (ER). Emergency thoracotomy or surgical resuscitation may be done first prior to ventricular repair.
Emergency thoracotomy is a procedure that allows immediate direct access to the chest to control bleeding and cardiac tamponade and treat injuries of the heart, lungs, or blood vessels in the chest. Emergency thoracotomy helps to assess the extent of injury and determine if cardiorrhaphy is required.
Cardiac trauma is divided into the following two mechanisms:
- Blunt injury: The heart may rupture following a blunt force trauma to the chest. This type of a trauma leads to instant death before the patient can present to the ER.
- Penetrating injury: The heart can get injured due to a trauma from penetrating sharp objects. Although lethal, the patient can be saved with timely treatment. One of the most common causes of death from penetrating trauma wounds is cardiac tamponade. Cardiac tamponade is a condition in which fluid fills up within the pericardium (the sac around the heart), leading to compression of the heart. Exsanguination is a severe loss of blood that can lead to death.
The ventricles in the heart are involved in 80% of penetrating cardiac injuries.
Why are ventricular repair (cardiorrhaphy) procedures performed?
A penetrating trauma to the chest in an unstable patient is an indication for emergency thoracotomy and possible cardiorrhaphy.
The indications for emergency thoracotomy with or without cardiorrhaphy include the following:
When are ventricular repair (cardiorrhaphy) procedures not done?
Contraindications for ventricular repair include the following:
- Clinically stable patients
- Blunt trauma with no vital signs
- Unsalvageable patients (decapacitated patients)
- Patient is deceased by the time they reach the hospital
How is a ventricular repair (cardiorrhaphy) procedure performed?
The surgery involves the patient being put under anesthesia. There are two different types of procedures in which a ventricular repair is performed.
- Thoracotomy procedure: A deep incision is made usually between the fourth or fifth intercostal space (the space between two ribs), which is below the nipple just to the left of the breastbone.
- Cardiorrhaphy procedure: The chest cavity is exposed. The major blood vessels and nerves supplying blood to the heart are identified and isolated. The wound in the heart is identified. Depending on the size, a finger or a catheter may be used to plug the wound until the surgeon prepares the suture material. The wound may be sutured or stapled in layers.
What are the complications of ventricular repair (cardiorrhaphy) procedures?
Potential complications of ventricular repair include the following:
- Injury to underlying structures in the chest such as the lungs, heart, blood vessels, nerves and esophagus (food pipe)
- Uncontrolled bleeding
- Postpericardiotomy syndrome (characterized by fever, chest pain, pericardial effusion, and electrocardiogram [ECG] changes)
- Arrhythmias (irregular heart rhythm)
- Postoperative infection
- Increased risk to physicians, nurses, and other staff of exposure to infectious blood and tissue such as HIV, Hepatitis B, etc., because it is an emergency procedure.
Health Solutions From Our Sponsors
Medscape Medical Reference
Top Why Ventricular Repair Cardiorrhaphy Procedures Related Articles
Cholesterol Drugs SlidesWhen diet and exercise aren't enough, should you turn to drugs? Learn cholesterol basics, drug classes, and available drugs along with their benefits and side effects.
Congestive Heart Failure (CHF)Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.
Coronary Heart Disease Screening Tests (CAD)
Coronary heart disease or coronary heart disease (CAD) screening tests can be used to potentially prevent a heart attack or cardiac event in a person without heart disease symptoms, and can assist in diagnosing heart disease in individuals with heart disease symptoms. Examples of coronary heart disease tests include:
- electrocardiogram (ECC, EKG),
- exercise stress test,
- radionuclide stress test,
- stress echocardiography,
- pharmacologic stress test,
- CT coronary angiogram, and
- coronary angiogram.
Heart CT ScanEBCT (also referred to as a calcium-score screening heart scan). This test is used to detect calcium deposits found in atherosclerotic plaque in the coronary arteries of heart disease patients. The more coronary calcium means more coronary atherosclerosis, which can raise the risk of future cardiovascular problems.
GERD (Acid Reflux, Heartburn)GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid contents of the stomach backs up into the esophagus. The symptoms of uncomplicated GERD are:
- regurgitation, and
Heart Attack (Myocardial Infarction)A heart attack happens when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical instability of the heart.
Heart Attack PreventionHeart disease and heart attacks can be prevented by leading a healthy lifestyle with diet, exercise, and stress management. Symptoms of heart attack in men and women include chest discomfort and pain in the shoulder, neck, jaw, stomach, or back.
Heart Attack Symptoms and Early Warning Signs
Recognizing heart attack symptoms and signs can help save your life or that of someone you love. Some heart attack symptoms, including left arm pain and chest pain, are well known but other, more nonspecific symptoms may be associated with a heart attack. Nausea, vomiting, malaise, indigestion, sweating, shortness of breath, and fatigue may signal a heart attack. Heart attack symptoms and signs in women may differ from those in men.
CAD SlideshowWhat is heart disease (coronary artery disease)? Learn about the causes of heart disease, arrhythmias and myopathy. Symptoms of heart disease include chest pain and shortness of breath. Explore heart disease diagnosis, treatment, and prevention.
Heart Disease QuizTake our Heart Disease Quiz to get answers and facts about high cholesterol, atherosclerosis prevention, and the causes, symptoms, treatments, testing, and procedures for medically broken hearts.
Heart Failure QuizWhat is heart failure? Learn about this dangerous condition, as well as who is at risk, and what to do about it.
Heart Lead ExtractionThe heart disease lead extraction procedure is needed when your leads are not working properly. This can be caused by: damage to the inside (called a fracture) or outside of the lead,large amounts of scar tissue form at the tip of the lead, causing it to need more energy to function than your pacemaker or ICD can deliver. This condition is known as "exit block," infection at the site of the device and lead implant.
Illustrations of the HeartThe muscle that pumps blood received from veins into arteries throughout the body. See a picture of the Heart and learn more about the health topic.
What Is a Heart Transplant?Heart transplant consists of three operations: 1) harvesting the heart from the donor, 2) removing the recipient's damaged heart, and 3) the implantation of the donor heart. The selection and distribution of donor hearts is a careful process so that the hearts are distributed fairly. For the patient requiring a heart transplant, all other important organs in the body must be in good shape. The most common complication of heart transplant is organ rejection.
Heart Valve Disease SurgeryHeart valves that are diseased can be treated both surgically (traditional heart valve surgery) and non-surgically (balloon valvuoplasty). The mitral valve is the most commonly repaired heart valve, but the aortic, pulmonic, and tricuspid valves may also undergo some of these repair techniques.
Heartburn Foods SlidesLearn the symptoms of heartburn and which foods cause heartburn or GERD. Discover home remedies and which foods may provide treatment for heartburn relief.
Lower Cholesterol TipsNeed to lower your cholesterol levels? Use these smart diet tips to quickly and easily lower your blood cholesterol levels. Choose heart-healthy foods to lower cholesterol and improve your heart health.
Cardiac Arrest QuizTake the Sudden Cardiac Arrest Quiz. Learning about this potentially deadly condition may save a life.